The purpose of this study is to examine Major Depression (MDD) in disaster survivors who have been most directly affected. MDD is usually the second most common disorder in disaster survivors with reported prevalence as high as 45%. However, it has been markedly under-studied by comparison to the literature on posttraumatic stress disorder (PTSD). We will be investigating (1) pre-disaster and disaster experience predictors of post-disaster MDD, (2) post-disaster symptoms that may serve as indicators of full MDD, and (3) coping behaviors in depressed survivors that prospectively predict current MDD at follow up years later. We propose a secondary analysis of datasets collected from 10 different disasters. These datasets were collected by the same team within a narrow timeframe after the disasters and include follow-up data for up to 3 years, allowing for a richer cross-disaster comparison than any prior study of post-disaster MDD. This is especially important because psychopathology varies tremendously in prevalence among disasters. This research has the potential to (1) help non-clinician disaster responders target high-risk individuals for MDD among disaster-exposed populations, (2) yield guidelines for screening procedures and inform future efforts to design a sensitive and specific screening instrument for post-disaster MDD, (3) help clinicians to identify coping behaviors and other factors that predict the level of functioning and the presence of MDD as reassessed years later. More broadly, this research has the potential to inform debates about whether and how post-disaster MDD differs from PTSD and from MDD in the general population by identifying similarities and differences between their risk factors.

Public Health Relevance

Not including terrorism and manmade disasters such as plane crashes, there are about 360 natural disasters a year globally, killing about 100,000 and affecting about 150 million others and prior studies suggest that between 10% and 45% [1] of survivors from these disasters will have Major Depressive Disorder. This study can have a significant impact on public health by identifying pre-disaster and disaster experience factors that predict this disorder, post-disaster symptoms that identify individuals at risk for the full syndrome and coping behaviors and other factor in survivors with MDD that can serve as predictors of the level of functioning and the presence of MDD as prospectively reassessed years later. Given the scarcity of clinical resources and the chaotic nature of disaster response, these results can inform future strategies to target those most at risk.